The latest news about Casey Anthony’s psychological state is that the young woman accused, but acquitted, of the death of her little daughter Caley, is about to see a female psychiatrist. Reportedly, she had previously been getting help from a “grief counselor.” Here are my reactions:

1. Seeing a “psychiatrist” implies that hopefully Casey will be getting a proper diagnosis – since speculation has been rampant about her condition. She has been labeled as narcissistic, psychopathic and a pathological liar. Her mother, Cindy Anthony, has publicly said, “I think there’s something seriously wrong with my daughter,” including a deficit in her “thought processes.” Cindy has even hypothesized that her daughter has “post partum schizophrenia” “a brain tumor” or “Grand Mal seizures” -- which have been questioned by experts and criticized as a way to excuse her behavior.

2. Consulting a psychiatrist implies that Casey will now be assessed for appropriate medication treatment, since “counselors” are usually not medical doctors and psychiatrists are licensed to prescribe medication for psychiatric disorders. Only a few states (e.g. Louisiana) have given prescription rights to licensed psychologists.

3. Likely, antidepressants will be considered, since Casey has multiple reasons in her life to be depressed. Her long and very public trial is very stressful. Further, she has suffered many losses, including the death of her daughter; “loss” of her parents (especially her father saying on TV’s Dr Phil show that she is to blame for her daughter’s death and that she is not welcome in their home); loss of a future “normal’ life; damage to her reputation (being called ‘the most hated woman in America”); and worse, threats to her life.

4. It has been reported that Casey will see a female psychiatrist. The gender of the therapist can be important for some clients, given what is called “transference” whereby the client unconsciously projects feelings, and repeats behaviors, with the therapist that come from past significant relationships. Often relationships from childhood with a parent are re-enacted. This dynamic affects the patient’s degree of openness, trust, honesty, comfort, subject matter, and behaviors in the sessions, as well as what is triggered in the sessions and enacted in life. While it is true that the degree of rapport between the therapist and patient matters most in the outcome of therapy, the matching of genders matters. For Casey, seeing a female can be positive, in that a male can trigger negative transference to the “father” figure, George, who is right now being critical and blaming, which would undoubtedly lead to Casey being furious at, and feeling betrayed by, him and any male authority figure. Conversely, her mother has defended her, and been the more stoic of her parents (George has been suicidal and also therefore not a role model of a strong male figure). Her mother also seems to have similar personality characteristics to Casey, which could predict a more positive identification and transference with a female therapist.

5. Therapists also have what’s called “counter-transference” with patients -- projecting past experiences onto the patient relationship. Of course, therapists are trained to recognize and control any entangled emotions and reactions, not letting them interfere with the therapeutic alliance or objectivity. A female therapist would have to be conscious of personal feelings about mothering (especially if she is a mother herself) and about any woman who might have been involved in their child’s death. A female therapist might be more understanding of a woman’s conflicts over mothering, or sympathetic about post-partum conditions, but it is also possible she would struggle with negative reactions like condemnation or hostility towards a woman’s lying, partying, irresponsibility towards mothering, or even being suspected of malicious actions towards a child.

6. Casey’s problems are more serious psychologically than can be adequately handled by just getting medication, or seeing any therapist in private sessions, even a few times a week. Psychiatrists these days usually see patients for short periods of time, mainly to check on their meds, and do not typically have the 45- minute “talk” sessions that psychologists and other mental health counselors typically do.

7. In my opinion, Casey should be in residential treatment, in a protected environment where she has a myriad of treatment sessions, and other therapeutic activities, every day.

With the explosive interviews of Cindy and George Anthony on Dr. Phil, my psychological observation is that their marriage is in trouble now more than ever before and can explode. Here is why:

Research shows that many couples who lose a child separate, as deep-seeded emotions, including guilt and blame, cause unresolved conflict. Granted Caylee is the Anthonys’ granddaughter, but (1) she had been like a child to them, given their attachment to her and given that Casey was hardly a hands-on mother; and (2) they have now “lost” their daughter since they are not in contact with her and George admits Casey is “not welcome at their home.”

They presented a somewhat united front during the years leading up to the trial, but this has crumbled, as demonstrated on the Dr Phil show when George spoke up about his theory about Casey’s involvement in Caylee’s death and Cindy, with disapproving looks throughout the show, said she had never heard him say those things before. George is now breaking out on his own – a loose cannon – which can cause intense “aftershocks”, e.g. blow-ups behind closed doors.

In response to their differing views on Caylee’s fate, Cindy says they can “agree to disagree.” From a psychological point of view, can you “agree to disagree” and make a marriage work? Yes; compromise in communicating and resolving disagreements are key to a healthy relationship (I have written extensively about this in my book, “The Complete Idiots Guide to a Healthy Relationship”). But some issues cannot withstand totally diverse opinions. This would include the Anthonys’ disagreement over whether their daughter was involved in their granddaughter’s death! It is hard to imagine a couple laughing over romantic dinners, or cuddling in bed, when one blames the daughter and she was involved (possibly with someone else) in their granddaughter’s demise while in stark contrast, the other is defending the daughter’s innocence. George blames Casey and says Caylee may be have been “sedated” so she could go out partying, which led to a worse outcome) and Cindy defends her daughter’s innocence, posing theories about her having “postpartum schizophrenia” or a ”grand male seizure” and saying she prayed to God that the trails’ outcome would show the truth, and that she believes the not guilty verdict did that.

The Anthonys are even victims of the intense public attention to their family dysfunction and drama. People are still glued to their story because it is a soap opera. The newest installment is Cindy and George’s appearance on TV in apparently candid interviews. With soap operas being cancelled on TV – much to the outrage of millions of fans -- people will be looking for more family dramas like these.

The Anthonys have a vast different style of coping with tragedy, which is even more evident now. Cindy is still covering up, while George is going in the opposite direction, unraveling and uncovering. George has admitted addiction (to gambling) and depression (even suicidal ideation). In contrast, Cindy uses defense mechanisms of denial and rationalization and appears to lie. A temper like hers could easily be directed at George, which he can turn inward.

The couple has to seek therapy to resolve many intense issues, especially as they have been played out in the public eye. Their need for therapy is evident even in their giving access to Dr Phil, instead of a news show.

Love and connection was not evident between the couple on TV. Although George did reach out to put his hand on Cindy’s knee at one point, Cindy smirked, and tightened her lips, on many occasions when George spoke, revealing more tension between them. They both displayed more downward glances than any caring glances towards each other.

Therapy should be couple counseling and also individual therapy. This is psychologically sound approach for couples with as severe issues to afce as the Anthonys. This was evident in Dr. Phil interviewing George on his own.

An issue that must be addressed in couples counseling as well as individual therapy is the accusations made by Casey’s lawyer of George having abused his daughter. Such accusations are exceptionally psychologically serious, and can serve to unstable an accused man and to enrage his wife and the mother of their child.

Control is another issue to address in therapy. Cindy has seemingly worn the pants in the family and George is now speaking his mind in disagreement with her.

George is in danger of re-emerging suicidal thoughts, given his revelations on television. After this airing, Cindy can be aggressively critical of him, his performance and what he said.

The drama that is unfolding will undoubtedly have another chapter. The Anthonys can be addicted to their TV personas, and the public will also want to see the next evolution of their story.

It is important to know how much the Anthony’s were paid to do theinterview. Clearly they have had financial troubles before.

New York, NY, September 8, 2011– The 10th anniversary of 9/11 occurs coincidentally with the time kids return to school and with the release by the New York Department of Education of a new curriculum that schools can use to teach students about the events of September 11. To address the potential stress of this time, and to help educate kids about 9/11,St. Luke’s-Roosevelt Hospital is including a special workshop at their 4th annual Child and Family Institute’s Back-to-School Event that includes self-esteem exercises, healing songs, and an exchange of dolls made by children from Haiti and Japan who survived the recent earthquakes and tsunami.

At the workshop, the New York children will be making dolls with messages of hope to be sent to kids in Haiti and Japan who have gone through the recent earthquakes there. Last month, 100 dolls were decorated by Japanese children after the recent tragic tsunami/earthquake in that country and brought to Haiti where they were given to children who survived the earthquake there.

“The circle of dolls makes the children who have gone through terrible tragedies know that children in other countries care about them. The psychological impact of this, and learning simple techniques to feel good, is healing and also fun,”

says noted New York clinical psychologist, Dr. Judy Kuriansky, founder of the Global Kids Connect Project, a popular radio and TV personality, and humanitarian and NGO representative at the United Nations for the International Association of Applied Psychology. Dr Judy provided psychological first aide after 9/11 at Ground Zero and at the Family Assistance Center in NYC, as well as after other disasters including Hurricane Katrina in New Orleans, the Asian tsunami, earthquakes in the Haiti and China.

Including New York youth in the circle of children is significant at this time, given the upcoming 10th anniversary of September 11 when New Yorkers will all be aware of the need for healing. Many of these children are dealing with other major stressors such as family problems, poverty, poor living conditions, and family financial problems that prevent them from essential school supplies.

“The doll exchange is based on sound psychological principles applied in other disasters, like the teddy bears given to children after 9/11, which represent ‘transitional objects’ and ‘contact comfort’ symbolic of a nurturing maternal figure offering security and safety essential for children after disasters,” adds Dr. Judy.

At the event, an original song, “Towers of Light,” written in commemoration of 9/11 to promote healing and honor the heroes of that day will be performed by the Stand Up for Peace Project (www.towersoflightsong.com). The song has been performed yearly at 9/11 memorials in New York, as well as in Japan and around the world, including for the Dalai Lama.

Other partners for the Event include Nozomi Terao, founder and Executive Director of HappyDoll, Inc. (www.happydoll.org) and formerly of Morgan Stanley; Russell Daisey, internationally known composer and co-founder of the Stand Up for Peace Project; Father Wismick Jean Charles, a Haitian Catholic priest who preaches in Westbury, Long Island and teaches at New York’s Fordham University; and the International Association of Applied Psychology, an NGO accredited at the United Nations. Partners in Haiti are Centre Bon Samaritan and The Haitian Action for the United Nations.

The Back-to-School Event fosters excitement about education by creating a fun environment with confidence-building activities designed to teach kids that academic success is key to achieving future goals. The Child and Family Institute in the Department of Psychiatry Outpatient Department provides therapeutic services to over 730 children and families with emotional, behavioral, family and learning issues. At last year’s Back-to-School Event, 130 children and teens participated in activities to promote school achievement, study skills and self-esteem. Refreshments and backpacks and other school supplies were donated by Staples, BJs, Whole Foods, the Discovery Center and others, and a computer was raffled off.

AVAILABLE: Press interviews with the kids, staff, donors & participants; photos and video of the Global Kids Connect event in Haiti and photos from the doll-making by children in Japan

Dr. Judy Kuriansky, Ph.D. is a clinical psychologist and relationship expert, teacher at Columbia University Teachers College and United Nations Main NGO representative who has provided disaster relief post-9’11 and around the world after disasters in Haiti, Sri Lanka, China and the Middle East. A former reporter for WCBS-TV, WABC-TV and host of CNBC-TV “Money and Emotions” and veteran radio advice talk show host of the popular “LovePhones” show, she now appears often as a TV commentator. A former columnist for the Daily News website and the South China Morning Post, and author of many books including “The Complete Idiots Guide to a Healthy Relationship,” and “Beyond Bullets and Bombs: Grassroots peace building between Israelis and Palestinians,” she was recently awarded for Lifetime Achievement in Global Peace and Tolerance by the Friends of the United Nations.

The Global Kids Connect Project is a cross-cultural humanitarian initiative promoting healing and comfort for children after disasters that includes a workshop of stress reduction techniques, cultural experiences and exchange of dolls. Partners include HappyDoll Inc., a Japanese-founded organization that has exchanged dolls for orphans and other children; the UN-accredited International Association of Applied Psychology; Haiti Action Youth for the United Nations; and New York’s St. Luke’s Hospital.

Hurricane Irene comes at an ironically opportune time, as emotions intensify with the approach of the 10th anniversary of the 9/11 terrorism attacks. While Irene is a natural disaster compared to the man-made terrorism of 9/11, emotional reactions – and coping -- are similar. My advice in the wake of Irene follows.

Talking about irony, yesterday I was in Australia, making a presentation about natural disasters at a psychology conference, saying that, at that very moment, a hurricane was hitting my own country. Also ironically, I had just finished a book about “Living in an Environmentally Traumatized World” about earthquakes, floods, tsunamis and how to cope. Given that I was talking in that presentation about being a first responder at major disasters around the world, and how to deal with the emotional impact, it hit me that I had to be home to do that very thing.

So I left two days early to make my way back to New York City when everyone was advised to evacuate. After getting to Washington, when all the NY airports were closed, I drove from Washington DC to New York – again despite advisories.

My message: “Get the facts, but also address the feelings.”

And to New Yorkers: Be prepared but do not panic.

Sadly, Irene has been a deadly storm that has tragically claimed lives and caused destruction in its wake. But as it hits New York City, the Tropical Storm has been downgraded to Category 1 storm. Certainly there is cause to be on alert -- stay off the roads and remain indoors. We have been warned, including by politicians -- who have to be super-cautious, especially in light of the disastrous way events like Hurricane Katrina were handled. And media has to give us the most drastic news. Some areas are hit worse than others – with flooding and power outages that will leave a “mess” -- but Irene is not as treacherous in the Big Apple as was thought. The rain out my window is as light as any other downpour.

Some professional reflections and advice for New Yorkers:

(A) For adults:

1) If there is no reason to go outside, don’t. But if you must, don’t be overly frightened.

2) Use being prepared as a lesson for any disaster. Even though Irene has lost her fury, the drill about what to do in an emergency is not just an intellectual exercise now, it’s a real run-through.

4) Make sure to have people you can count on, staying in touch continually. (My friend Russell was emailing me from the moment the news hit, telling me about travel options not just generally but that apply to my exact situation).

5) Be aware of any past experiences when you have felt out of control or trapped, that could be triggered

6) Manage your reactions by doing something to feel in control. Do reassuring self talk (“I can take care of myself and my loved ones”. Do relaxing breathing exercises.

1) Pay particular attention to how kids are reacting. Since they’ve been told to stay at home, you don’t want them to be frightened to go out. Fears of going outside can lead to their not wanting to go to school this week, for fear of what would happen to them or to you.

2) Don’t reveal to kids your own fears of what could happen, to prevent escalating their fears.

3) Use this experience as a teachable moment about “Acts of Mother Nature” – offering a geology and natural science lesson, but also a practical lesson about what they should do in emergencies (where to find shelter, numbers to call to reach you and others) 4) Be reassuring, that you will keep them safe, and that others (the mayor, police, electrical company, etc.) are doing what they can to keep them safe. Make them feel safe by holding them, giving them attention. 5) Put precautions in place. (e.g. make sure they have a cell phone or a way to get in touch with you).

(6) Have kids participate in making that family emergency kit (flashlight, canned food, etc.)

(7) Be reassuring: “This might be scary but remember we have this plan in place about what to do to be safe". (8) Limit – as much as possible – their seeing sensationalized stories on TV or internet (e.g. of children being lost, orphaned; pets being abandoned).

(9) Keep kids involved in some useful activity.

(10) Ask children what they think about the situation to correct any inaccurate ideas, and ask how they feel, to address their emotions.

Some personal experience and reflections:

While everyone was first being told to evacuate my city- or to stay indoors and not drive– I choose to drive INTO the storm.” As I mentioned, I had been in Sydney Australia -- at a board meeting and conference of an organization I represent at the United Nations (the World Council of Psychotherapy) -- and changed my ticket to come home two days early to be here in my city. Why? Because I was talking at the conference about coping with natural disasters, so how could I not be in my city when one such event was happening? I had been here during 9/11 and have been a “first responder” in many natural disasters on these shores (e.g. Hurricane Katrina), and worldwide (e.g. the earthquake in Haiti and China, and the Asian tsunami). And because I anticipated that dealing with the emotional aspect of things would be important, when all the news was being covered.

All the airports in the NY area were closed, and the United airline personnel at the Sydney airport advised me to stay in Australia — or they could get me as far as San Francisco and then only back to NY on Wednesday! Not good enough, said I. Besides, I had to be in Bonn Germany by Friday for a UN conference. Fortunately, I thought to ask about flying in to a neighboring city (lesson: you should always think about those options for yourself as someone else might not!). Surprise, the Washington D.C.(Dulles) airport was open! Of course, it could close by the time I reached the states but I took the chance anyway, to get closer to home and with trust that I’d figure something out when I arrived (lesson: always have plan B,C, etc.)

When I got to DC, all trains and buses were cancelled. How to get there? Hertz- rent-a-car! Lesson: when you are really determined, you can find a way to make something happen. I believe, "There is always a way."

Foolhardy to drive? People would think so, given the expectation of high winds and pounding rain. But I didn’t believe I would be in any danger. Inside, I felt calm and knew I would be safe -- a valuable feeling in an emergency. I was also relieved to see a few other cars, and even a number of emergency vehicles on the road. I was also reassured remembering that I have been on the road in far worse conditions of wind and rain. Once on the NY Turnpike in winter, my car was being thrown out of my lane by high winds and slipping on sheets of ice, as pellets beat the windshield. And just two weeks ago, sleeting rain on the Jersey Turnpike made cars crawl at 5 miles an hour.

Driving on the Jersey Turnpike up to NYC in the wee hours of this morning, I reflected about how some of my philosophies were confirmed.

1) Worse case scenarios don't always manifest. A big storm was once before supposed to hit NYC, but died down and even turned off shore.

2) Tuning in to my inner voice about what to do is useful. Of course, backing up intuition with some data also helps. In this case, I heard Mayor Bloomberg say on TV, at midnight when I was standing in the Hertz Rental Car, “Go to sleep, and I’ll speak to you more in the morning.” Go to sleep! If there had been a real emergency, no one should be sleeping, Trees might be falling, and windows might be shattering. If the Mayor and all of us should go to sleep, it would certainly be safe to drive.

3) Fear does not have to manifest. I never felt frightened on the highway and was always confident that the road would be clear. This, despite warning signs with red-lit lettering. One read “Hurricane Warning, seek shelter”. Another said “Flooding ahead, after exit 11” and another, “Standing Water. Take alternate route.” We had already driven through one big puddle on the highway near Baltimore -- before the sign -- and there was only one tiny puddle after the sign. The rain was light at times, and never to the point where you couldn’t see out of the windshield. Mayve the signs hadn't ben updated. Another sign on the Jersey Turnpike said “Road closed,” while I had called my sister to look online and she found no such warning. Lesson: checking the internet for traffic conditions is useful.

4) Luck – or some divine intervention – plays a role in natural disasters. My friend who was driving was panicked about crossing the Delaware Bridge, given its height and exposure. But when we got there, the rain – and wind -- totally stopped. All was calm as we crossed the bridge, adn then when we got to the end, the rain started dribbling again. It was as if a God had a hand in that.

Knowing a lot about sexuality education, I have strong reactions to the new policy in New York to tecah sex ed in the schools. I know a lot about kids learning about sex rather NOT learning about sex -- having hosted the most popular radio call-in show for years on Z100 radio that was syndicated around the country (similar to Lovelines with Dr Drew), and having written many books about the topic, including Generation Sex (young people’s questions about sex) (http://www.drjudy.com/generation-sex/) and a 4-volume set called “Sex Education: Past Present and Future.” (http://www.abc-clio.com/product.aspx?id=54439

My important points about the new sex education policy:

1. Incorporating sex education in the schools is a very positive move especially in light of the fact that kids do not talk about sex at home, that studies show they learn mostly from media and from friends, with the latter leading them to not only MISleading information but also to peer pressure to be sexual.

2.Critics say that talking about sex makes kids go out and do it. Dr Judy sown studies as well as research by other experts have shown this is not true. In fact, the opposite is the case: that sex education helps kids to resist early sex, and if they do have sex, they are more careful about with whom and about practicing safer sex.

3.Classes about sex education of course have to be age- appropriate.

4.The new sex policy us careful to avoid controversial issues, like not showing how to put condoms on, but just describing the process, and providing an option for teens to find out more information privately

5.Parents should be offered sexuality education! This used to be available from Planned Parenthood but lack of funding dried these programs up. Now that kids will be learning in school, parents need to learn too, since they are often ignorant about issues and need guidance about how to answer kids questions.

6.The best sex education is "comprehensive" and includes information about love and relationships as well as sexuality and body functioning

The so-called butt-slasher has been pricking women in the rear end with sharp objects, in malls in Fairfax Virginia. Sic women have reported being victimized so far, on e while shopping at T.J. Maxx, and another 18 year old at a Forever XXI store, who felt a ‘sharp pain” and believed a hanger had stuck her, though she notied a man beinding down to pick up clothes supposedly fallen off a rack.

.

The perpetrator has a sexual paraphilia called “piquerism,” getting sexual satisfaction from slashing, piercing or pricking women in sexual areas of the body..

The target could be the breasts, genitals or rear end. My analysis – as a Freudian- -- for hwy his proclivity was an attack on the butt. A boy can be subjected to a mother taunting him, ‘you’re a bad boy’ and going to be punished and then giving him a rear end beating, which is sexually stimulating. He then associates being attacked on the rear with sexual tuirn-on. Add to this, that he gets satisfaction from mother’s attention, albeit negative. And he comes very angry at her, wich explains how he then projects his punishment urges onto women.

Such a paraphiliac perversion also means that the man is incapable of a healthy relationship with a real woman, and can only focus on a body part.

The perversion can also come from being beaten by the father with a belt to the point of drawing blood.

There is always a danger that such a paraphiliac already acting on aggressive urges can become a lust murderer.

1. Feelings of the public are at an all-time high giving people an opportunity to express themselves about many issues raised by the case, like justice, truth, parenting, lying, sex and drugs in youth, family dysfunction, and the law. It is causative that people can use this case and this verdict as a chance to talk about these major issues but then they need to not just discuss Casey Anthony case, but also how these issues apply in their own lives. In other words after discussing what a bad parent Casey is, and talk about parenting in your own experience and children.2. Casey Anthony being proven innocent feels like a farce and an outrage just like the O. J. case who lose confidence in the justice system and the law. From a psychological point pf view, even though the law was carried out to the letter and there was obviously reasonable doubt, most people know and feel in their guts, that she is guilty and that Casey got away with murder. The problem is that the letter of the law is often at odds with what could be the truth. The facts of a case can be totally opposite to the feelings about it but the legal system is hand-strung and people can lose confidence.3. The outrage over Casey's acquittal offers warnings: A. to families and schools to teach good parenting B. to families and schools to teach family life skills and sex education C. to young girls not to get pregnant D. to programs that communities and the government need to institute about sex and drug use in young people E. to all levels of society not to tolerate "bad girl" behavior that is being promoted with wild behavior in the media and on TV shows giving extremely dangerous role models including shows like "Teen Mom" and Internet postings that perpetuate stories about teens, sex, drugs, partying and aggression. F. social service programs for family therapy need to be funded since the Anthony family are such a perfect example of a dysfunctional family with the daughter's acting out, the mothers lying and the fathers depression and suicidal behavior.4. All of these issues should be discussed in every household that has been obsessed with this case instead of just arguing about the verdict.

In the latest exposé of disgraced former Congressman Anthony Weiner’s sexual behavior, photos surfaced of his donning a bra and women’s hose in college. The pictures were reportedly taken by a college friend in 1982 when the now 46-year old Weiner was a sophomore student at the State University of New York in Plattsburgh.

Teenage behavior aimed at shock value – including such cross-dressing – is not uncommon, as I know from years of hearing teens report about their activities on my radio call-in advice show.

Some might be inclined to be further disgusted by the ex-pol’s behavior, but the desire to wear women’s clothes deserves more detailed analysis.

Dressing in underwear of the opposite sex can be a prank, advanced creative sex play between consenting partners, or part of a problem.

The behavior, like any other sexual activity, becomes a problem if the person cannot have a loving intimate relationship with a partner, make wise judgments about how and when to engage in the behavior, or gets into trouble with his relationship, career or the law.

A major myth needs to be corrected. While some cross dressers – called transvestites -- are gay and a few are stage performers, the majority are heterosexual, married with children and working in respectable jobs.

The behavior ranges from secretly trying on their wife’s clothing, to hiding female panties under their business suit, to full dress-up with make-up and wigs for outings in public hoping to “pass” as a woman. Some cross-dressers adopt names for their “femme” persona, so Michael wants to be called Michelle and John renames himself Joan.

For thousands of cross dressers in this country (and also worldwide), the behavior allows relief from demands of masculinity, affords permission to feel beautiful, adored and taken care of, and offers a chance to experience both masculine and feminine sides of himself.

As one man explains, "I like my male organ, but I also love knowing what it feels like to be a woman."

Powerful men may engage in this behavior as a way to symbolically escape pressures to be in control or aggressive by assuming the role of a more passive and submissive female. For this reason, the behavior is often accompanied by sexual activity characterized by dominance-submission or sado-masochism. Such men may want their partner to play a “male” or dominant role, or may frequent a professional dominatrix.

Of course, unlike regular Joes, Weiner’s added status as a political figure affords him the opportunity and sense of entitlement to indulge his sexual fantasies and attract willing partners.

What about Weiner’s wife, then? Why doesn’t he just do those things with her? The answer lies in the "Madonna-prostitute" syndrome, whereby such men act out their erotic wild sex fantasies with a woman they can treat as a "slut" in order to keep his public partner, a wife or mother to his children, pure and pristine. With Weiner’s wife Huma being pregnant, this split is even more pronounced. Also, while in principle Huma’s status as a powerful Alpha female in her public life (as the Secretary of States’ aide, traveling around the world meeting world leaders) would qualify her to dominate a man, her character precludes her from being likely to be receptive to these of her husband’s sexual fantasies.

Wives of cross-dressing men have been given ratings according to their acceptance of their partner’s behavior. In one survey, one in five wives demanded divorce and were given an "F," while one in four who got an "A" welcomed a "female" friend to go shopping with.

These “A” female partners may even request that he trade his pants for her panties where the role reversal gives her a sense of power and that he appreciates women.

"When he's dressed like a girl, he really knows, like another woman would, how to please me sexually,” one woman enthusiastically told me.

In the privacy of love chambers, a man can don his lover’s lingerie to give them both a thrill over role-playing the opposite sex, or trading traditional roles of power and control.

One man explained his cross-dressing as an outgrowth of homework given to him in couples’ therapy to learn how to please his wife by “walking a mile in her shoes.” He took it literally, and squeezed not only into her shoes but her underwear too. Getting in her garb was a way to get inside her head.

Cross-dressing has a social context. Men are stigmatized by dressing or acting like the opposite gender, while the opposite does not apply. Women are allowed to display traditionally masculine behavior and to dress like men, like actor Diane Keaton so often seen in suits.

As a psychologist, I must point out the difference between sex play and cross dressing urges and behavior that can lead to the man’s suffering guilt and depression in private.

One source offering support for these men is Miss Vera’s Finishing School for Boys who want to be Girls. Groups provide a safe place for these men to explore their identity and classes offer training about clothing, voice inflection, and gait.

Academy founder and sexologist Veronica Vera, whose philosophy is “Venus Envy,” says, “For every woman who burned her bra, there is a man eager to wear one.”

The name of Miss Vera’s school is somewhat misleading, though, because men who really want to be a woman are not transvestites, but “transgender,” who feel born in the wrong body and seek sex reassignment.

Psychological explanations of cross-dressing range from envy of the opposite sex, frustration with male roles and restrictiveness of male fashion, to genetic predispositions, in-utero hormonal imbalances, and childhood searches for mother’s approval.

Cross- dressing can start when a teenage boy in a bathroom casually grabs his mother's undergarments to masturbate into, or, on a deeper level, when a little boy puts on mother’s clothes to feel close to an absent or adored female figure.

It is one thing to reveal such behavior to a grown-up partner, but coming out to children is far more complicated. For one family I worked with, the father chose to tell his children on Halloween, when dressed up as a woman, he explained that he enjoys doing this in his life on other occasions. At first, the children were confused and embarrassed (especially that peers would find out and tease them) but they eventually accepted the behavior once the family did not fall apart.

Cross dressers challenge us to question what it means to be a man or a woman and the advantages of each gender.

Congressman Weiner was forced to go into therapy as “damage control” given the timing of colleagues calling for his stepping down from office he insisted he would not leave. He had no choice.

But he really needs treatment. While he hasn't said what that rehab will be, it undoubtedly will address his sexual behavior.

Like similar bad boys caught in reviling sex scandals -- Arnold, Tiger Woods, Spitzer -- going to rehab for a short time for “sex addiction” is just a band aid, giving in to public pressure demanding some responsibility and response, garnering sympathy. In reality, the problems underlying these lewd and inappropriate acts are deep and require much more intensive therapy.

Therapy should address multiple levels:

Therapy for Weiner himself: (1) Sexual problems and sex addiction evidenced in his inability to control sexting to multiple women who are strangers and the latest scandal about one of these women being 17 years old; (2) deeper psychological problems, evidenced in his personality traits of narcissism and arrogance; exhibitionism, (exposing his naked body parts and bringing attention to his genitalia); poor judgment and low self-esteem underlying his arrogance; character flaws (evidenced in sexting on his personal couch with cats and family photos behind him); chronic infidelity and inability to maintain healthy intimacy in his relationship (reaching out to women on ‘lower’ levels than his Alpha female wife). To become a better father (as his statement said), he needs to explore his fears of fatherhood and “growing up” since his teenage-like behavior reveals immaturity (evidenced in his sexting to a teen who was a fan following him on twiiter and in using an adolescent and derogatory word for female private parts when referring to his cats). All this will require exploring the patterns while he was growing up and his relationship with his own father.

Therapy for Huma: She needs to address a likely conflict in her roles as a wife (marrying a man even after he told her about his cybersex behavior, as he admitted) distinct from her career role as an Alpha woman (Secretary of State Hillary Clinton’s right hand aide). This can involve soul-searching about how she could be so close to Hillary and repeat Clinton’s own marital trials (given that Clinton has referred to her as her second daughter). Therapy should explore influences on her choice of partner including her cultural background and family dynamics, for example, her father died when she was a teen, and had established an interfaith institute (which coincides with her interfaith marriage).

Marriage counselingand sex therapy for Weiner and his wife. Huma needs to express her anger towards her husband for this scandal in their marriage and also for tainting her reputation and career, as well as her fears about motherhood and their future. He needs to make new promises to her and new commitments. They need to explore what was missing in their intimate life that allowed his behavior to go on, unchecked. Then they need to make new agreements and set up monitoring to insure commitment.

Prognosis for therapy: Short-term therapy – the typical 30 day rehab center treatment -- will not work. As his problems are deep, his urges will not easily be erased, and may only intensify now that Huma is pregnant. He will be forced to control his behavior under such intense scrutiny, but once the limelight goes off him, he will be tortured by his impulses and needs. Also, his Madonna-Prostitute syndrome will intensify as her pregnancy advances. This means the man splits women into the pure mother figure (Madonna mother of Christ) whom he cannot defile with his wild sex fantasies and instead acts them out in affairs with sexpot women with whom he does not have any responsibility or commitment. To address all thses issues and to insure his fidelity, he needs longer-term treatment and they need couples therapy throughout her pregnancy and when the baby is born.